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Aseptic Abscesses and Inflammatory Bowel Disease: Two Cases and Review of Literature.

Abstract Background. Aseptic abscesses (AA) are sterile lesions that represent an extraintestinal manifestation (EIM) of inflammatory bowel disease (IBD). Though Canada has the highest prevalence of IBD in the world, reports of IBD-associated AA are absent in Canada. This may represent a different IBD phenotype or underrecognition and underreporting. Purpose. To explore AA as a possible EIM of IBD and evaluate clinical and investigative findings among patients with IBD-associated AA. Methods. Retrospective chart and literature reviews were performed to find cases of IBD-associated AA at our institution and in the literature. Results. We identified 2 cases of IBD-associated AA in our institution. Both patients had ulcerative colitis and presented with fever, abdominal pain, and weight loss. Radiological workup and aspiration showed sterile splenic abscesses. The AA were unresponsive to antibiotics. One patient improved on corticosteroids and one underwent splenectomy. We retrieved 37 cases of IBD-associated AA from the literature. All patients showed no evidence of infection, failed to resolve with antibiotics, and, if attempted, improved on corticosteroids. Conclusions. Our cases are the first reported in Canada. They support literature which suggests AA as an EIM of IBD and may help increase recognition and reporting of this phenomenon.
PMID
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Aseptic abscesses: a study of 30 patients with or without inflammatory bowel disease and review of the literature.

Authors

Mayor MeshTerms
Keywords
Journal Title canadian journal of gastroenterology & hepatology
Publication Year Start




PMID- 28265555
OWN - NLM
STAT- MEDLINE
DA  - 20170307
DCOM- 20170314
LR  - 20170314
IS  - 2291-2797 (Electronic)
IS  - 2291-2789 (Linking)
VI  - 2017
DP  - 2017
TI  - Aseptic Abscesses and Inflammatory Bowel Disease: Two Cases and Review of
      Literature.
PG  - 5124354
LID - 10.1155/2017/5124354 [doi]
AB  - Background. Aseptic abscesses (AA) are sterile lesions that represent an
      extraintestinal manifestation (EIM) of inflammatory bowel disease (IBD). Though
      Canada has the highest prevalence of IBD in the world, reports of IBD-associated 
      AA are absent in Canada. This may represent a different IBD phenotype or
      underrecognition and underreporting. Purpose. To explore AA as a possible EIM of 
      IBD and evaluate clinical and investigative findings among patients with
      IBD-associated AA. Methods. Retrospective chart and literature reviews were
      performed to find cases of IBD-associated AA at our institution and in the
      literature. Results. We identified 2 cases of IBD-associated AA in our
      institution. Both patients had ulcerative colitis and presented with fever,
      abdominal pain, and weight loss. Radiological workup and aspiration showed
      sterile splenic abscesses. The AA were unresponsive to antibiotics. One patient
      improved on corticosteroids and one underwent splenectomy. We retrieved 37 cases 
      of IBD-associated AA from the literature. All patients showed no evidence of
      infection, failed to resolve with antibiotics, and, if attempted, improved on
      corticosteroids. Conclusions. Our cases are the first reported in Canada. They
      support literature which suggests AA as an EIM of IBD and may help increase
      recognition and reporting of this phenomenon.
FAU - Bollegala, Natasha
AU  - Bollegala N
AUID- ORCID: 0000-0002-4742-4500
AD  - Division of Gastroenterology, Women's College Hospital, Toronto, ON, Canada.
FAU - Khan, Rishad
AU  - Khan R
AUID- ORCID: 0000-0002-5090-7685
AD  - Division of Gastroenterology, St. Michael's Hospital, Toronto, ON, Canada.
FAU - Scaffidi, Michael A
AU  - Scaffidi MA
AD  - Division of Gastroenterology, St. Michael's Hospital, Toronto, ON, Canada.
FAU - Al-Mazroui, Ahmed
AU  - Al-Mazroui A
AD  - Division of Gastroenterology, St. Michael's Hospital, Toronto, ON, Canada.
FAU - Tessolini, Jenna
AU  - Tessolini J
AD  - Division of Gastroenterology, St. Michael's Hospital, Toronto, ON, Canada.
FAU - Showler, Adrienne
AU  - Showler A
AD  - Division of Infectious Disease, St. Michael's Hospital, Toronto, ON, Canada.
FAU - Colak, Errol
AU  - Colak E
AD  - Department of Medical Imaging, St. Michael's Hospital, Toronto, ON, Canada.
FAU - Grover, Samir C
AU  - Grover SC
AUID- ORCID: 0000-0003-3392-1220
AD  - Division of Gastroenterology, St. Michael's Hospital, Toronto, ON, Canada.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
DEP - 20170206
PL  - Egypt
TA  - Can J Gastroenterol Hepatol
JT  - Canadian journal of gastroenterology & hepatology
JID - 101623613
SB  - IM
MH  - Abdominal Pain/etiology
MH  - Abscess/*etiology
MH  - Adult
MH  - Canada
MH  - Colitis, Ulcerative/*complications
MH  - Female
MH  - Fever/etiology
MH  - Humans
MH  - Inflammatory Bowel Diseases/*complications
MH  - Male
MH  - Retrospective Studies
MH  - Splenic Diseases/*etiology
MH  - Weight Loss
PMC - PMC5317120
COI - The authors declare that they have no competing interests.
EDAT- 2017/03/08 06:00
MHDA- 2017/03/16 06:00
CRDT- 2017/03/08 06:00
PHST- 2016/08/18 [received]
PHST- 2016/12/22 [revised]
PHST- 2017/01/22 [accepted]
AID - 10.1155/2017/5124354 [doi]
PST - ppublish
SO  - Can J Gastroenterol Hepatol. 2017;2017:5124354. doi: 10.1155/2017/5124354. Epub
      2017 Feb 6.

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